Polite Dissent

By request, here’s a look at the Death of Superman. Well, not the death so much as what happened immediately afterwards.

The Adventures of Superman #498 “Funeral for a Friend, part 1: Death of a Legend”
Jerry Orday, writer
Tom Grummet, penciler

Let’s start with a quiz:

Q: What killed Superman?
A: Editorial mandate.

Q: OK, good answer, but not what I was looking for. What killed Superman?
A: A lot of punches (and a neck butt or two) from Doomsday.

Q: Another good answer, but still not what I was looking for. Once again, what killed Superman?
A: Bad medicine.

Exactly. There’s no doubt Superman would have died anyway, but his rescuers forgot the most basic part of emergency medicine: the ABCs: Airway, Breathing and Circulation. This simple mnemonic is there to remind us of the first items that need to be assessed and treated in any emergency.

Guardian: Ugnhh! His lungs are like steel tanks — all I’ve got doesn’t even get a rise out of his chest!

I give Guardian some credit. While everyone else is standing around gawking, he’s the first to react and try to resuscitate Superman. He attempts some rescue breathing, but is unable to get the lungs to inflate well. You’ll notice that he jumped straight to B (Breathing) and skipped over A (Airway). Superman’s just been in horrible fight and sustained a great deal of damage. He took blows to the face and neck, so there’s going to be swelling and damage to the mouth and trachea. This trauma is why Guardian can’t inflate the lungs (though Kryptonian physiology may have a little to do with it too). Superman needs an open airway to breathe; intubation is the best option. Once he’s been intubated, rescue breathing with an ambu-bag should be started. Still, Guardian did better than the other rescuers who started directly on C (Circulation).

Superman is found to have no pulse, but no one starts CPR. That should be the next step. (Of course it could be argued that it would take enhanced strength to be able to compress Superman’s chest enough for CPR to work…)

Guardian: Being invulnerable is going to make injection, or an IV impossible!

This is an excellent point; however, modern emergency medicine is prepared for situations like this. While we don’t generally encounter patients with invulnerable skin, there are situations where IV access is impossible to obtain. When this happens, the medications can be placed down the endotracheal tube — whoops! Superman was never intubated and doesn’t have an endotracheal tube. There’s that pesky A for airway again…

Finding no pulse, the rescue team immediately begin shocking Superman with a defibrillator. I’ve talked at length before about shocking pulseless patients and whether it’s a good idea. In this case, there’s no IV access and nothing to lose, so go for it.

When the regular defibrillator fails, Professor Hamilton bring in his homemade super-high-voltage defibrillator (technically defibrillators deliver joules, not volts). Despite repeated attempts, this attempt at restarting the heart fails too and Superman is declared dead.

Let’s face it: when the editor wants you dead, you’re dead, so the rescuers had no real chance to revive the Man of Steel. They certainly get an A for effort, but they should have paid a little more attention to the ABCs.